Value of Serum vWF and Treg-Related Cytokines in Risk Stratification and Efficacy Evaluation of Children with Acute Leukemia
Objective To explore the value of serum von Willebrandt factor(vWF),regulatory T cell(Treg)related cytokines[transforming growth factor-β(TGF-β),interleukin-10(IL-10),interleukin-35(IL-35)]in risk stratification and efficacy assessment of children with acute leukemia(AL),and provide reference for clinical diagnosis and treatment of AL children.Methods A total of 78 children with AL admitted to the Third Affiliated Hospital of Zhengzhou University from February 2020 to August 2022 were selected and divided into three subgroups according to the risk stratification of the CCLG-ALL-2018 protocol:low-risk group(39 cases),intermediate-risk group(21 cases)and high-risk group(18 cases).The levels of serum vWF,TGF-β,IL-10,and IL-35 in children with different types and different risk stratifications were compared and analyzed.All children with AL received standardized treatment,and were divided into a clinically effective group(complete remission+partial remission,62 cases)and a clinically ineffective group(no remission,16 cases)based on the 1-year efficacy evaluation results.The levels of serum vWF,TGF-β,IL-10,and IL-35 were compared between the two groups at 2 and 6 months of treatment,and their predictive value for the efficacy of treatment in children with AL was analyzed.Results The levels of serum vWF,IL-10 and IL-35 in the low-risk group were lower than those in the medium-risk group,and the levels of serum vWF,IL-10 and IL-35 in the medium-risk group were lower than those in the high-risk group(P＜0.05).The level of serum TGF-β in the low-risk group was higher than that in the intermediate-risk group,while the level of serum TGF-β in the intermediate-risk group was higher than that in the high-risk group(P＜0.05).Spearman correlation coefficient analysis showed that serum vWF,IL-10,and IL-35 were positively correlated with the risk stratification of AL children,while serum TGF-β was negatively correlated with the risk stratification of AL children(P＜0.05).After 1 year of treatment,28 cases of complete remission and 34 cases of partial remission were included in the clinically effective group(62 cases),and 16 cases of no remission were included in the clinically ineffective group(16 cases).The levels of serum vWF,IL-10,and IL-35 in the clinically effective group at 2 and 6 months of treatment were lower than those in the clinically ineffective group,while the level of serum TGF-β was higher than that in the clinically ineffective group,with statistically significant differences(P＜0.05).The area under the curve of the combined prediction of serum indicators for clinical failure in children with AL were 0.875 and 0.933 at 2 and 6 months of treatment,respectively(P＜0.05).Conclusion Serum vWF,TGF-β,IL-10 and IL-35 are related to risk stratification and therapeutic effect in children with AL.Dynamic monitoring of serum vWF and Treg-related cytokines is beneficial to the evaluation of disease condition and therapeutic effect.
acute leukemiacurative effectvon willebrand factorregulatory T cellsinterleukin-10interleukin-35transforming growth factor beta
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